Scapular Winging Syndrome

Scapular Winging Syndrome

Common Medical Diagnoses:

  • glenohumeral impingement (anteriorly)
  • tendinopathy
  • bursitis
  • rotator cuff tear
  • thoracic outlet syndrome and neural entrapment
  • long thoracic nerve neuropathy

Description:

Shoulder pain due to instability of the medial side of the scapula.  This is a result of weakness or coordination problems with the serratus anterior muscle.  This winging is frequently at rest, but most notable during any reaching movement.

Diagnostic tests:

  • Correction of scapular position during overhead reaching reduces shoulder pain.
  • weak serratus anterior
  • short pectoralis minor
  • short scapulohumeral muscles

Treatment:

  • Improve serratus anterior strength / muscle activation.
  • Stretch pectoralis minor
  • Taping for postural alignment
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2 thoughts on “Scapular Winging Syndrome

    1. Depending on the level of patient’s capabilities, it could be as easy as supine protraction holds. I especially like a bottoms up kettlebell protraction and hold (maybe + active ER/IR). To begin closed chain, I would start with quadruped protraction hold and progress to push up position. Eventually, doing holds with 1 arm and then some active motion with the other. Lastly, trying to maintain a wide scapular position during a partial or full ROM push up is incredibly challenging for this patient in the long run.

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